What is ARTA?
ARTA stands for Androgen Receptor Targeted Agents. These medicines are used to treat metastatic prostate cancer – a type of prostate cancer that has spread to other parts of the body.
ARTA works by blocking the action of male hormones (androgens) like testosterone, which fuel the growth of prostate cancer cells.
Common ARTA medications include:
- Enzalutamide (Xtandi)
- Apalutamide (Erleada)
- Darolutamide (Nubeqa)
- Abiraterone – given with a steroid like prednisolone
Your oncology doctor will prescribe the one most suitable for you.
How is it taken?
Follow your oncology doctor’s instructions.
Enzalutamide is taken once a day, with or without food.
Apalutamide is taken once a day, with or without food.
Darolutamide is taken twice a day, with or without food.
Abiraterone is taken once a day, it must be taken at least two hours after eating and food must not be eaten for at least one hour after taking the tablets.
All tablets must be swallowed whole with water.
Take your medication at the same time each day.
Do not stop or miss doses unless told to by your Oncology Doctor/Nurse.
If you forget your daily dose do not take extra tablets the next day to make up for any dose missed. Carry on as normal the next day.
Contact your treatment team for advice if you have any concerns about missing a dose.
Why have I been prescribed ARTA?
You have been prescribed ARTA because:
- Your prostate cancer has spread (metastasised) beyond the prostate.
- It is either hormone-sensitive (responsive to hormone therapy) or castration-resistant (still growing despite low testosterone levels).
- ARTA can slow cancer progression, reduce symptoms and improve survival.
Possible side effects:
Like all medications, ARTA can cause side effects. Not everyone will experience them. Tell your cancer doctor or nurse if you notice anything unusual.
Common side effects:
- Tiredness or fatigue
- High blood pressure
- Joint or muscle pain
- Hot flushes
- Low energy or mood changes
- Falls or dizziness
- Weight gain
- Reduced sex drive or erectile dysfunction
Specific to some ARTA drugs:
Abiraterone: Liver changes, low potassium, fluid retention, high blood pressure
Enzalutamide: Seizures (rare), confusion, falls
Apalutamide: Rash, fractures, weight loss
Darolutamide: Fewer brain-related side effects (less likely to cause seizures or confusion)
Monitoring and check-ups:
You will have regular blood tests to check:
- Liver function
- Kidney function
- Potassium levels (for Abiraterone)
- Full blood count
- PSA levels (a marker of prostate cancer activity)
Blood pressure (BP) – Purchase a home BP monitor, record your blood pressure ahead of starting ARTA medication to ensure you do not have any untreated high blood pressure (hypertension). Write down your readings. During treatment take your BP on a weekly basis. Your cancer doctor and nurse team will want to know what your BP is before and during your treatment – see additional guidance on recording your BP and acceptable BP readings later in this patient information.
Keep all appointments and tell your healthcare provider about any side effects or new symptoms.
Important warnings:
- Do not father a child while taking ARTA – use effective contraception. ARTA can harm an unborn baby.
- Inform all healthcare providers (including dentists) that you are on ARTA.
- If you are taking Abiraterone, also take the steroid exactly as prescribed to avoid side effects like adrenal insufficiency. Do not stop your steroid abruptly; speak to your oncology team if you have any concerns.
Lifestyle tips:
- Eat a healthy, balanced diet.
- Stay active – gentle exercise like walking can help fight fatigue.
- Avoid or reduce your alcohol intake. Seek further advice from your oncology doctor or nurse team.
- Manage stress and ask for emotional support if needed.
Speak to your nurse team for additional lifestyle advice and information.
You can also contact the Macmillan Information and Support Service:
https://www.ulh.nhs.uk/services/macmillan/
Or view the Lincolnshire Cancer Support website for further information and support for lifestyle https://www.cancersupportlincolnshire.nhs.uk/
When to contact your oncology team urgently:
- Raised Blood Pressure (BP) – if consistently above 150/95 (see blood pressure advice in next section)
- Severe dizziness or fainting
- Unusual bruising or bleeding
- Severe muscle weakness or cramps
- Signs of infection (e.g. fever, chills)
- Shortness of breath or swelling in the legs
- Confusion or seizures
- Rash that is irritating and not improving by applying moisturising cream to your skin
Additional advice – Blood Pressure
ARTA drugs can cause a rise in your blood pressure (Hypertension). This is why you are asked to monitor your BP while taking these drugs. Ideally your blood pressure should remain below 150/95. Should you see readings above this regularly you need to inform the oncology team on the contact numbers below. The team will need to discuss your readings with you and give you advice on taking your ARTA medication. You might need to stop taking your ARTA while your blood pressure is controlled. You must seek advice and not stop your ARTA or continue taking your ARTA without speaking to your oncology team if your BP is high.
If you notice high blood pressure please start to record your blood pressure twice a day, morning and evening. Sit quietly for a few minutes before taking the readings. Take two readings at least a minute apart. Keep a record of the readings. Make an appointment with your General Practitioner (GP) and take a week of BP readings for them to review. It might mean you need to be started on medication to help control your blood pressure.
Make sure you have spoken to the treatment nurses and have a plan to be reviewed by the treatment team again in the coming weeks regarding your blood pressure.
Additional information can be found on the NHS choices link: https://www.nhs.uk/conditions/high-blood-pressure/
Contact Information
If you have questions or concerns about your medication, contact your oncology team.
Monday to Friday 9am to 5pm
Lincoln – Ingham 01522 572260
Boston – Chemotherapy Suite 01205 446548
Grantham – Emerald Suite 01476 464653
Oncology Assessment unit 01522 307841
Out of hours and Bank holidays
Lincoln – Waddington Unit 01522 307199
Boston – Bostonian Ward 01205 445347
Remember: this patient information leaflet is a guide. Always follow the instructions given by your doctor or oncology treatment nurse.